The US Food and Drug Adminsitration (FDA) has approved Actemra (tocilizumab) to treat COVID-19 in hospitalized adults who are receiving systemic corticosteroids and require supplemental oxygen, noninvasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).

The approval was supported by data from 4 randomized, controlled studies that evaluated tocilizumab, an interleukin-6 receptor antagonist, for the treatment of COVID-19 in more than 5500 hospitalized patients. The trials include the RECOVERY ( Identifier: NCT04381936), EMPACTA ( Identifier: NCT04372186), COVACTA ( Identifier: NCT04320615), and REMDACTA ( Identifier: NCT04409262) studies. 

In the RECOVERY trial, hospitalized patients with severe COVID-19 pneumonia were randomly assigned 1:1 to receive tocilizumab plus standard care (n=2022) or standard care alone (n=2094). The probability of death by day 28 (primary endpoint) was 30.7% in the tocilizumab arm and 34.9% in the standard care arm (hazard ratio [HR], 0.85; 95% CI, 0.76-0.94; P =.0028). The median time to hospital discharge was 19 days for tocilizumab-treated patients and more than 28 days for those receiving standard care alone.

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The EMPACTA trial included 389 patients hospitalized with COVID-19 pneumonia who were randomly assigned 2:1 to receive tocilizumab (n=249) or placebo (n=128). Tocilizumab was associated with a reduction in progression to mechanical ventilation or death; 12% of patients treated with tocilizumab required mechanical ventilation or died by day 28, as did 19.3% of those who received placebo.

Findings from the COVACTA and REMDACTA trials contributed to the safety assessment of tocilizumab when used as treatment for COVID-19. The most common adverse reactions (incidence of at least 3%) were constipation, urinary tract infection, hypertension, anxiety, diarrhea, insomnia, and nausea.


FDA approves Genentech’s Actemra for the treatment of COVID-19 in hospitalized adults. News release. Genentech. Accessed December 21, 2022.

This article originally appeared on MPR